Magnetic resonance imaging of the transplanted pediatric heart as a potential predictor of rejection

摘要

AIM To evaluate cardiac magnetic resonance imaging(CMR) as a non-invasive tool to detect acute cellular rejection(ACR) in children after heart transplant(HT).METHODS Thirty pediatric HT recipients underwent CMR at the time of surveillance endomyocardial biopsy(EMB) and results were compared to 14 non-transplant controls. Biventricular volumes, ejection fractions(EFs), T2-weighted signal intensities, native T1 times, extracellular volumes(ECVs) and presence of late gadolinium enhancement(LGE) were compared between patients and controls and betweenpatients with International Society of Heart and Lung Transplantation(ISHLT) grade ≥ 2R rejection and those with grade 0/1R. Heart rate(HR) and brain natriuretic peptide(BNP) were assessed as potential biomarkers.RESULTS Significant ACR(ISHLT grade ≥ 2R) was an infrequent event in our population(5/30, 17%). Ventricular volumes,EFs, LGE prevalence, ECVs, native T1 times, T2 signal intensity ratios, HR and BNP were not associated with the presence of ≥ 2R ACR.CONCLUSION In this pilot study CMR did not reliably identify ACRrelated changes in pediatric HT patients.